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1、循序渐退法行左侧双腔支气管插管的临床研究实用医院临床杂志2011年9月第8卷第5期循序渐退法行左侧双腔支气管插管的临床研究颜勇军,郑珈琳,钟庆2,汪辉德2,陈涛2,邬瑞目02,陈光忠2(1.四川省安岳县人民医院麻醉科,四川安E-642350;2,四川省简阳市人民医院麻醉科,四川简阳641400)【摘要】目的探讨循序渐退法用于左侧双腔支气管导管(1eft.sideddoublelumenendobronchialTube,L.DLT)插管及纤维支气管镜(fiberopticbronchoscope,F
2、OB)辅助插入深度的定位.方法80例实施择期开胸和胸腔镜手术的全麻患者采用计算机随机法分为传统听诊法组(A组)和循序渐退法组(w组)各40例.均采用静脉麻醉诱导,待患者意识丧失肌肉松弛后行L—DLT操作.w组采用循序渐退法行左侧双腔支气管插管;A组按传统听诊法定位.观察定位时间,FOB检查置管深度,实际到位率以及气管插管相关并发症.结果定位时间两组差异无统计学意义(P>0.05),置管深度和实际到位率A组均明显优干w组(P<0.05).经FOB检查,A组错位原因中插入过深最主要,且明显多
3、于w组(P<0.05).结论循序渐退法用于左侧双腔支气管插管,能够显着提高正确到位率.【关键词】双腔支气管导管;纤维支气管镜;开胸手术【中图分类号】R614.24;R616.5;R655【文献标识码】A【文章编号】1672-6170(2011J05-0060-03Clinicalstudyongradualwithdrawalmethodwithleft.sideddouble.1umenendObrOnchialtubefortrachealintubationYANYong-jun,ZHE
4、NGJia—lin,ZHONGQing,WANGHui—de..CHENTao.,WURui—gang,CHENGuang—zhong(1.DepartmentofAnesthesiology,AnyuePeople~Hospital,Anyue642350-China;2.DepartmentofAnesthesiology,JianyangPeople~Hospital,Jianyang641400,China)【Correspondingauthor]ZHONGQ【Abstract】Objec
5、tiveThisstudyaimedtoinvestigativegradualwithdrawalmethodontrachealintubationbyleft—sideddouble—lumenendobronchialtube(L?DLT)andpositioningofthedepthofpenetrationfiberopticbronchoscope(FOB).MethodsEightya—dultpatientswhoscheduledforvideo—assistedor/andt
6、horacicsurgerywererandomlyassignedtogroupA(n=40)usingtraditionalauscultationmethodandgroupW(n=40lusinggradualwithdrawalmethodfortrachealintubation.Afterstandardintravenousanes—theticinduction.insertionofL-DLTwasperformed.IngroupW,gradualwithdrawalmetho
7、dwasusedtoinsertL—DLT.IngroupA,traditionalauscultationmethodwasusedtoposition.Thetimeofpositioning,depthofintubation,casesofidealanatomicplacementandincidenceofcomplicationswererecorded.ResultsTherewerenostatisticalsignificanceinthetimeoftracheaintubat
8、ion(P>0.05).ThedepthofintubationingroupAwasdeeperthanthatofgroupW,butcasesofidealanatomicplacementwaslessthanthatofgroupW(P<0.05).OverinsertionofL—DLT,whichwasthemainreasonsofinappropriatelocationofintubation,ingroupAwasmorethanth
